> LDN for MS—University of California, San Francisco

Bruce Cree, MD and co-researchers at the Multiple Sclerosis Center at UCSF published their study “Pilot Trial 0f Low Dose Naltrexone and Quality of Life in MS” in the online Annals of Neurology on 19 Feb 2010.

The study began in early 2007. Some 80 patients with MS were involved in this double-blind, “randomized, placebo-controlled, crossover-design study of the effects of low dose naltrexone on quality of life as measured by the multiple sclerosis quality of life inventory.” Each subject received either LDN or a placebo for 8 weeks, followed by one week without either, and then a further 8 weeks on the the alternate capsule. A substantial contribution toward the study was made by the voluntary LDN for MS Research Fund.

The results were published in February 2010 in the Annals of Neurology (full pre-publication text available here):

Objective:
To evaluate the efficacy of 4.5 mg nightly naltrexone on the quality of life of multiple sclerosis patients.

Methods:
This single center, double-masked, placebo-controlled, crossover studied evaluated the efficacy of eight weeks of treatment with 4.5 mg nightly naltrexone (Low dose naltrexone or LDN) on self reported quality of life of MS patients.

Results:
80 subjects with clinically definite multiple sclerosis were enrolled and 60 subjects completed the trial. 10 withdrew before completing the first trial period: 8 for personal reasons, 1 for a non-MS related adverse event and 1 for perceived benefit. Database management errors occurred in 4 other subjects and quality of life surveys were incomplete in 6 subjects for unknown reasons. The high rate of subject dropout and data management errors substantially reduced the trial’s statistical power. LDN was well tolerated and serious adverse events did not occur. LDN was associated with significant improvement on the following mental health quality of life measures: a 3.3 point improvement on the Mental Component Summary score of the SF-36 (P=.04), a 6 point improvement on the Mental Health Inventory (P<.01), a 1.6 point improvement on the Pain Effects Scale (P=.04) and a 2.4 point improvement on the Perceived Deficits Questionnaire (P=.05).

Interpretation:LDN significantly improved mental health quality of life indices. Further studies with LDN in MS are warranted.

> LDN for Fibromyalgia—Stanford University, Palo Alto, California

A single-blind, small clinical trial of LDN for the treatment of fibromyalgia was begun at Stanford Medical Center in June 2007; principal Investigator Sean Mackey and sub-investigator Jarred Younger. The results were published as “Fibromyalgia Symptoms are Reduced by Low-Dose Naltrexone: a Pilot Study” in Pain Med. 2009 May-Jun;10(4):663-72. Younger reports:

The LDN trial on 10 individuals gave us encouraging results. The findings warranted a larger, double-blind trial [involving] individuals with fibromyalgia, which is ongoing now in the San Francisco Bay area. We are also pursuing a small trial of LDN for pediatric fibromyalgia patients.

> LDN for MS—Milan, Italy

A long-awaited pilot study of low dose naltrexone therapy in multiple sclerosis was run by the Milan neurological researcher, Dr. Maira Gironi and colleagues. Several northern Italian hospitals began enrolling patients for the study during the first week of December 2006. Dr. Gironi reports that the 6 months of LDN treatment was completed in August 2007. Importantly, Dr. Gironi’s research team in Milan has long been a locus for significant research on endorphins in relation to illness, and this study has been tracking accurate assessments of the patients’ beta-endorphin levels in response to their LDN treatment.

The subjects were 40 patients affected with Primary Progressive MS. PPMS is an uncommon form of multiple sclerosis that progresses inexorably and for which neurologists have never had an approved treatment to offer.

Abstract: A sixth month phase II multicenter-pilot trial with a low dose of the opiate antagonist Naltrexone (LDN) has been carried out in 40 patients with primary progressive multiple sclerosis (PPMS). The primary end points were safety and tolerability. Secondary outcomes were efficacy on spasticity, pain, fatigue, depression, and quality of life. Clinical and biochemical evaluations were serially performed. Protein concentration of beta-endorphins (BE) and mRNA levels and allelic variants of the mu-opiod receptor gene (OPRM1) were analyzed. Five dropouts and two major adverse events occurred. The remaining adverse events did not interfere with daily living. Neurological disability progressed in only one patient. A significant reduction of spasticity was measured at the end of the trial. BE concentration increased during the trial, but no association was found between OPRM1 variants and improvement of spasticity. Our data clearly indicate that LDN is safe and well tolerated in patients with PPMS.

[Editor’s Note: That only one patient showed any progression of PPMS during the six-month period of this trial is extraordinary, as is the occurrence of a statistically significant reduction in spasticity. Two major adverse events were reported but were unassociated with MS or with LDN: one patient had previously unrecognized polycystic kidney disease and the other was diagnosed with metastatic lung cancer.]

> LDN for Crohn’s disease—Penn State College of Medicine, Hershey, PA

Dr. Jill Smith’s original article, “Low-Dose Naltrexone Therapy Improves Active Crohn’s Disease,” was published in the Jan 11, 2007 online edition of the American Journal of Gastroenterology (2007;102:1–9) [print edition Apr ’07]. This was the first clinical study of LDN published by a US medical journal. Dr. Smith, Professor of Gastroenterology at Pennsylvania State University’s College of Medicine, found that two-thirds of the patients in her pilot study went into remission and fully 89% of the group responded to LDN treatment to some degree. She concluded that “LDN therapy appears effective and safe in subjects with active Crohn’s disease.” That open-label Penn State trial demonstrated the efficacy of LDN in a small group of patients.

As a result, Dr. Smith received an NIH grant that permitted a more definitive Phase II placebo-controlled clinical trial. The 40 patients completed the study in 2009 and publication is awaited. Dr. Smith intends to make the general results known in an oral presentation during the first week in May 2010 at Digestive Disease Week meetings at the New Orleans Convention Center. She remains very optimistic about the usefulness of LDN in inflammatory bowel diseases, such as Crohn’s disease. (See the “Low Dose Naltrexone Therapy for Crohn’s Disease” link here.)

Dr. Smith’s most recent research on the effects of LDN is a double-blind placebo controlled Phase ll study of youngsters from ages 6 to 17 with active Crohn’s disease. It was launched at Penn State in July 2008 and is expected to run until July 2010. Participants “will be treated with either naltrexone or placebo for the first 8 weeks then all subjects will receive active naltrexone drug the last 8 weeks.” For information about joining the trial, contact Sandra Bingaman, RN, at 717-531-8108 begin_of_the_skype_highlighting 717-531-8108 end_of_the_skype_highlighting or sbingaman@psu.edu. (Please see the trial website.)

> LDN for HIV—Mali, Africa

In September 2007, after years of preparatory efforts by many advocates, the Institutional Review Board in Bamako, the capital of Mali, finally approved plans for a clinical trial of LDN in people who are HIV-infected—the first scientific study of LDN for HIV/AIDS in Africa. Signing up of the volunteer subjects has already begun. The neurologist Dr. Jaquelyn McCandless has taken on the responsibilities of “Expatriate Clinical Monitor” for the medical aspects of the trial.

The study, which is placebo controlled and should last for some 9 months per patient, involves 3 study groups: LDN treatment only; LDN plus antiretroviral drugs; and only antiretroviral drugs. Because of the severe stigma attached to HIV infection in Mali, as of October 2008 the total number of participants who had reached 6 months time in all 3 groups combined amounted only to 16 people. However, Dr. McCandless reported that sign-ups were beginning to improve markedly. The volunteer subjects were 18 years of age or older and must have reduced CD4 counts in the 350 to 600 cells range at the outset for the LDN treatment only group. The other two groups must begin with CD4 counts below 350 and must be asymptomatic at that time. Laboratory studies are being rechecked at 12-week intervals. Completion of the study and data analysis is anticipated for Spring 2010.

The research team is led by Dr. Abdel Kader Traore and other health officials at the University Hospital in Bamako. Irmat Pharmacy of Manhattan originally supplied all of the original 4.5mg LDN and matching placebo capsules at no cost. However, due to untranslated English-French communications, the study was approved for 3mg LDN dosage, and that is being supplied by Skip’s Pharmacy of Boca Raton. In addition, the plans include careful attention to counseling aimed at improving preventive health practices for women and children. Both Dr. McCandless and her colleague husband, Jack Zimmerman, plan to be in Mali from time to time to supervise the study.

Dr. McCandless is actively seeking philanthropic donations (e-mail her here). The Fourth LDN Conference of October 2008 was proud to be able to donate $5,595 dollars from voluntary individual contributions.

> LDN for MS—Akron, Ohio

In May 2007, the MindBrain Consortium and the Department of Psychiatry of Summa Hospital System of Akron, Ohio, along with the nearby Oak Clinic for the treatment of Multiple Sclerosis, announced a new scientific study of the effects of treating MS with low dose naltrexone. Psychologist David Pincus and his colleagues coordinated the study. It was a 16 week, double-blind, randomized, placebo-controlled, crossover-design analysis of 36 patients with either progressive or relapsing-remitting MS. The study examined symptom severity as well as any changes in quality of life, sleep patterns, and affective states.

In early October 2007, Dr. Pincus wrote as follows:

We have enrolled more than 20 of the 36 people intended; we expect to be fully recruited within the next 3 or 4 weeks, and, three months following the end of enrollment we will have all the data. The study is going well, a couple of people have dropped out or been removed for one reason or another, but none because of a problem with sleep. One patient had sleeping issues for a few nights, but then has been ok. We are looking at the psychoactive properties of LDN as well as assessing improvement of MS symptoms, and hope to find some changes in perception of energy level that correlate with personality type and amount of dreaming reported.

One year later, Dr. Pincus reported problematic outcomes in his study, with little apparent differences between the placebo and treatment groups. After lengthy consideration with his colleagues, he wrote as follows:

We did not exclude patients on existing immunosuppressants….The existing immunosuppressants may have inhibited the LDN effects in this population.

> Research on Neurodegeneration at NIEHS Suggests a Protective Naltrexone Role

J.S. Hong, Ph.D., head of the Neuropharmacology Section of the Laboratory of Pharmacology and Chemistry at the National Institute of Environmental Health Sciences, finds that “morphinan” drugs, including naltrexone and naloxone, are able to reduce inflammatory reactions in microglia brain cells in animal studies. Such inflammation is believed to be central to the progressive neurodegenerative effects seen in disorders such as Parkinson’s disease and Alzheimer’s disease. Hong’s report, summarizing the role of microglia in inflammation-related neurodegeneration and the potential of therapy using morphinans, appears in a January 2007 issue of Nature Reviews Neuroscience [8(1):57-69].

> Research at Penn State: LDN for an Animal Model of MS

The National Multiple Sclerosis Society “awarded a small Pilot Award to Ian Zagon [Ph.D.] at Pennsylvania State University in Hershey, PA for the term of 09/01/2006 through 08/31/2007 in the amount of $44,000. The title of his project is ‘Role of opioid peptides and receptors in MS.’ This study [treated] an animal model of MS daily with either a high dose of naltrexone or a low dose of naltrexone to determine whether naltrexone influences disease course.”

Zagon described the project as follows:

This research project raises the question of whether endogenous opioids and opioid receptors influence the course of MS. This is a novel and innovative concept that is valuable to explore. To test this hypothesis, we will subject [rodents] to experimental autoimmune encephalomyelitis (EAE), a model that mimics MS. Animals will be treated daily with a high dose of [naltrexone] (HDN) or a low dose of [naltrexone] (LDN)….Our expectations are that continuous opioid receptor blockade will exacerbate the progression of MS, whereas a low dose of naltrexone will retard the course of this disease. Evidence for the involvement of endogenous opioids and opioid receptors in MS will open a new field of research related to the pathogenesis of this disease, and contribute to the development of strategies for treatment.

Dr. Zagon’s expectations were met, as is clear in the titles of the two poster presentations (below), which he gave to the World Congress on Treatment and Research in Multiple Sclerosis, held in September 2008 in Montreal, Canada. The actual data still awaited journal publication at that date:

> Penn State Trial for Crohn’s Disease

Endoscopic Improvement in Crohn’s Colitis with Naltrexone

Figure A: Shown is the rectum of a subject with active Crohn’s Disease before starting therapy with naltrexone 4.5 mg/day. The mucosa is ulcerated, edematous, and inflamed.Figure B: Shows the same area of the rectum in the same patient four weeks after naltrexone therapy. The lining is now healed, ulcers resolved, and the mucosa is healthy.Copyrights: do not reproduce the above images and captions without written permission from Jill P. Smith, MD, Professor of Medicine, H-045 GI Division, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033

The report on this groundbreaking research—“Low-Dose Naltrexone as a Treatment For Active Crohn’s Disease”—was presented on May 23, 2006 at Digestive Diseases Week, a prestigious gastrointestinal conference, by Professor Jill Smith of the Pennsylvania State University College of Medicine. Dr. Smith’s research paper, “Low-Dose Naltrexone Therapy Improves Active Crohn’s Disease,” has been published by the American Journal of Gastroenterology in its January 11, 2007 edition.

According to the news from Penn State, the National Institutes of Health has already granted $500,000 for Dr. Smith’s group to continue the study. This funding should help assure a full-fledged placebo-controlled scientific trial of LDN in Crohn’s disease. (Notably, Dr. Smith and her research teams are also involved in exploring the direct effects of using a form of endorphin by infusion in order to treat pancreatic and colon cancer.)

Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA.

Health Evaluation Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA.

Neural and Behavioral Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA.

Methods: Eligible subjects with histologically and endoscopically confirmed active Crohn’s disease with a Crohn’s Activity Index (CDAI) score of 220-450 were enrolled in a study using 4.5 mg naltrexone/day. Subjects were required to be off infliximab for at least 8-weeks, and this medication was not allowed during the trial. Other drug therapy for Crohn’s disease utilized 4 or more weeks prior to enrollment was continued at the same dosages…. Drug [LDN] was administered orally each evening for a 12-week period. Laboratory tests, erythrocyte sedimentation rates, C-Reactive protein, and CDAI scores were assessed monthly and 4 weeks after discontinuing the medication.

Eighty-nine percent of patients exhibited a response to therapy (>70-point decrease in CDAI, p<0.001) and 67% achieved remission (CDAI score <150). QOL* surveys indicated marked improvement with LDN. No laboratory abnormalities were noted. One subject undergoing routine endoscopic procedures showed healing of the intestinal mucosa. In both subjects with open fistulas, closure was noted with LDN. The most common side effect of LDN was sleep disturbances (7 patients).

In December 2005, Pain Therapeutics, Inc. announced results of its Phase III study with PTI-901. [Editor’s Note: PTI-901 contains only 0.5mg of naltrexone, which is well below the therapeutic dosage range for LDN—normally from 1.75mg to 4.5mg every night. LDN in the normal dosage range has been anecdotally reported quite beneficial in halting IBS.] Excerpt from PTI’s announcement:

This randomized, double-blinded, multi-center U.S. study compared a daily dose of PTI-901 against placebo in 600 women with documented IBS over a three-month treatment period. PTI-901 showed a favorable safety profile and patients reported statistically meaningful relief of IBS symptoms in the second month of treatment (p<0.02), but the drug did not demonstrate a meaningful benefit in the third month of treatment, which was defined as the primary endpoint. According to current regulatory standards, an experimental drug for chronic IBS needs to show efficacy at the end of a three-month treatment period.

The Company believes this study was well designed to detect any durable benefits of PTI-901 versus placebo in a large patient population with IBS. Based on the adequacy of the study itself, coupled with today’s clinical results, the Company is discontinuing all further clinical development activities with PTI-901.

> Dr. Evers Trial in Germany for Multiple Sclerosis (MS)

Conducted in the Multiple Sclerosis Clinic of Dr. Evers Hospital in Sundern, Germany, the starting date was October 15, 2004. It is described as a short-term scientific, randomized, placebo-controlled, double-blind study involving patients with either secondary-progressive MS (SPMS) or primary-progressive MS (PPMS).

[Editor’s Note: Unfortunately, because of some early complaints of sleep disturbance, the principal investigator of this trial switched all of the study group to taking LDN at 9am in the morning, a questionable dosage time. It is generally recognized that the most effective time to take LDN is at bedtime, between 9pm and 3am, due to the fact that the endorphins for each day are always produced at their peak rate in the pre-dawn hours. A 9am dosage time, as was used in this trial, might conceivably suppress—rather than boost—a patient’s immune system.]

The purpose of the study was to investigate what MS-associated symptoms are positively influenced by LDN (low dose naltrexone, 3 mg per day). The principal investigator, Dr. Mir, reported his findings at the First Annual LDN Conference in 2005, as well as on his website.

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A few days ago marked my first 100 days on low-dose naltrexone and I’m happy to report that this endorphin therapy has boosted my central nervous system to a near normal state. I no longer feel depressed (without an anti-depressant) I feel HAPPY! I’m having some issues with my legs still but now that I’m not a freaking basket case I can address those. Who would have thought that an old drug used for addiction would put my life back together physically and mentally. I feel so fortunate that I found this only 8 months after my official diagnosis, what if I had NEVER found it? I shudder to think of what my non-life would be like. It hurts that I’ve lost friends, lost time, lost a bit of my life to Fibromyalgia, but in other ways, if you look hard, this has given me my life back better and lovelier than before. Life is all how you look at it, and LIFE IS GOOD~ 🙂

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I’ve been through a hell of a lot in my life, divorced parents at age 5, alcoholic father, chronically ill mother, I lived with grandparents, uncles and aunts, father and step mother, etc. I lived my teenage years in a poor neighborhood with my mother, got into sex, (had 3 abortions) drugs, and abusive boyfriends at age 15, no parental guidance, got pregnant (had my first child) at 21, unmarried, my husband (and father of 2 of my children) is an ex drug user, I had an affair at age 26 which resulted in a child, (this part deleted due to privacy issues) so I haven’t lived any kind of fairytale life. Then I’m cruisin’ along, happy, good job, new car, great kids, husband I actually think is gonna make it for the long haul and BAM… Seizures, migraines, myoclonus, hysterectomy, FIBROMYALGIA/CFS, life fuckin’ sucks for the most part ya know? Could I be diagnosed with PTSD… Probably? My mom is dx’d with it. I personally (and this is my opinion) think its a crutch diagnosis. If you saw war, a murder, something truly traumatic, I believe in that meriting a dx. I don’t however think its a diagnosis for people who have had crappy lives. I think its a cop out. I’m not asking anyone to agree with me, or judge me, as I don’t judge you. I just think when a person is ready to be happy, you’ll find a way to do that, and if you aren’t… You wont. Wow. (That was some good venting)

Posted by Patty Rowe with WordPress for BlackBerry.

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How do I explain this to you my family and friends? This is very difficult to do as my illness is “unseen.” So allow me to begin by thanking you for taking the time out of your day to spend some time with me and get to know me better. A person’s time is their most valuable asset and yours is appreciated

{{{Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points – places on your body where slight pressure causes pain. Myofascial pain syndrome is a chronic form of muscle pain. The pain of Myofascial pain syndrome centers around sensitive points in your muscles called trigger points. The trigger points in your muscles can be painful when touched. And the pain can spread throughout the affected muscle.}}}

I want to talk to you about fibromyalgia (FM) and Chronic Myofascial Pain Syndrome (MPS). Many have never heard of these conditions and for those who have, many are misinformed. And because of this, judgments are made that may not be correct. So I ask you to keep an open mind as I try to explain who I am and how FM/MPS has assaulted not only my life but those whom I love as well.

I cannot show you a physically open wound to show how much pain I’m in. If I could you would take one look at that, tell me to sit right down, get me a pillow, offer me something to eat or drink and have that concerned and understanding look on your faces. However with Fibromyalgia, you will hear from many people that they would rather have a broken leg any day than suffer the kind of pain these disorders inflict. To me, a broken leg is even a poor example to compare suffering to these disorders and an insult to those of us with those disorders.

You see, I suffer from a disease that you cannot see; a disease that there is no cure for and that keeps the medical community baffled at how to treat and battle this demon, who’s attacks are relentless. My pain works silently, stealing my joy and replacing it with tears. On the outside we look alike you and I; you wont see my scars as you would a person who, say, had suffered a car accident. You won’t see my pain in the way you would a person undergoing chemo for cancer; however, my pain is just as real and just as debilitating. And in many ways my pain may be more destructive because people can’t see it and do not understand….

You must see with your ears and your heart what your eyes cannot see. You must listen carefully to what I am telling you. What I describe to you may not make much sense to you and may be difficult for you to understand. Sometimes it may seem to you to be a different universe that I discuss. Know that it probably is. You don’t have to fully understand my universe and you cannot possibly. However hear my pain, listen for red flags always of any danger signals where you may need to help with added assistance. I like to call it “sending in the troops.” Anytime I do not seem in touch with reality.

Please don’t get angry at my seemingly lack of interest in doing things; I punish myself enough I assure you. My tears are shed many times when no one is around. My embarrassment is covered by a joke or laughter, but inside I want to die. You will hear many things from me that to you seem as easily resolvable. You may wonder why I make the same “wrong” decisions over and over again. Why haven’t I learned by this time? Why can’t I see the senselessness of my behavior? I may seem to be getting my life together and them bottom out all over again.

Please understand the difference between “happy” and “healthy”. When you’ve got the flu you probably feel miserable with it, but I’ve been sick for years. I can’t be miserable all the time, in fact I work hard at not being miserable. So if you’re talking to me and I sound happy, it means I’m happy. That’s all. I may be tired. I may be in pain. I may be sicker than ever. Please, don’t say, “Oh, you’re sounding
better!” I am not sounding better, I am sounding happy.

What is happening here? Am I lazy, stupid, etc? Nope. My physical brain and body is very different than yours. I experience life different than the way you do. I feel different than you do. Most of my “friends” are gone; even members of my own family have abandoned me. I have been accused of “playing games” for another’s sympathy. I have been called unreliable because I am forced to cancel plans I made at the last minute because of the burning and pain in my legs or arms and shoulders. The pain can be so intense that I cannot put my clothes on and I am left in my tears as I miss out on yet another activity I used to love and once participated in with enthusiasm. Do I experience mood swings? If I am hurting I may be angry, sad, depressed, or any of the hundred moods in the world. I’ll never know what mood I will wake up with? I may treat you cruelly and say horrible things to you; I may ignore you completely, or cry on your shoulder unstopping when I’m in Fibro Flair. You may wonder what you said or did that made me this way. Well you did nothing it’s the Fibromyalgia and all its underlining factors causing this.

{{{While the most predominant symptoms of fibromyalgia include widespread pain and persistent fatigue, the resulting cognitive impairment of this condition may be its most maddening. Commonly referred to as fibro fog, this symptom is a conglomeration of cognitive challenges. Fibro fog is understood to be a physical symptom of fibromyalgia, not a psychological one. Just as no two individuals experience fibromyalgia in the same way, fibro fog also has a varying range of indications, including: Mental confusion, Fuzzy thinking, Short-term memory loss, Inability to concentrate or pay attention, and Language lapses}}}

This is why I feel like a child at times. Just the other day I put the egg’s I bought at the store in the pantry, on the shelf, instead of in the refrigerator. When I talk to people, many times I lose my train of thought in mid sentence or forget the simplest word needed to explain or describe something. Please try to understand how it feels to have another go behind me in my home to make sure the stove is off after I cook an occasional meal. Please try to understand how it feels to “lose” the keys, only to find them in the freezer. As I try to maintain my dignity the Demon assaults me at every turn.

I have a physical illness and it isn’t my fault and I didn’t ask for it I don’t want it and I don’t deserve it.

{{{Occurring at the deepest level of the sleep cycle, individuals with fibromyalgia typically lack sufficient restorative sleep. We know that at the deeper levels of sleep, called delta wave sleep, a person’s mind conducts internal housekeeping. During delta wave sleep, newly acquired information is assimilated and integrated into the brain. The inability to get sufficient delta wave sleep impairs the ability to recall information and operate at a normal level of mental efficiency.}}}

Sleep, when I do get some, it is restless and I wake often because of the pain the sheets have on my legs or because I twitch uncontrollably. I walk through many of my days in a daze with the Fibro-fog laughing at me as I stumble and grasp for clarity.

Just because I can do a thing one day, that doesn’t mean I will be able to do the same thing the next day or next week. I may be able to take that walk after dinner on a warm July evening; the next day or even the in the next hour I may not be able to walk to the fridge to get a cold drink because my muscles have begun to cramp and lock up or spasm uncontrollably. There are those who say “but you did that yesterday!” “What is your problem today?” The hurt I experience at those words scars me so deeply that I have let my family and friends down again; and still they don’t understand.

On a brighter side I want you to know that I still have my sense of humor. If you take the time to spend with me you will see that. I love to tell that joke to make another’s face light up and smile at my wit. I am fun to be with if you will spend the time with me on my own playing field; is this too much to ask? I want nothing more than to be a part of your life. I have found that I can be a strong friend in many ways. I am your friend, your supporter and many times I will be the one to do the research for your latest project; many times I will be your biggest fan and the world will know how proud I am at your accomplishments and how honored I am to have you in my life.

All I ask is that you become educated about fibromyalgia. I am someone in your life that suffers from fibromyalgia. You may think you know everything there is to know about it, but there is more information out there than you think. It is more complicated then you think, and it is more life changing then you think.

{{{Lend a helping hand. If you want to be helpful to someone with fibromyalgia, just ask what you can do. Be flexible with invitations and plans that you have made. Understand that sometimes the pain of fibromyalgia is overwhelming. Be active. Accompany them to a doctor’s appointment and take an active interest in their treatment. You can take notes at the doctor’s office and then review your notes together at home. Don’t take things personally. Some people with fibromyalgia suffer from sudden mood changes. Try not to take these mood swings personally as they are part of the syndrome.}}}

So you see, you and I are not that much different. I too have hopes, dreams, goals and this demon Do you have an unseen demon that assaults you and no one else can see? Have you had to fight a fight that crushes you and brings you to your knees? I will be by your side, win or lose, I promise you that; I will be there in ways that I can. I will give all I can as I can, I promise you that. But I have to do this thing my way. Please understand that I am in such a fight myself and I know that I have little hope of a cure or effective treatments, at least right now.

Thank you for spending your time with me today. I hope we can work through this thing, you and me. Please understand that I am just like you.